Idaho hospital system sues state AG to get more accommodations for ’emergency’ abortions

Believing that the new Trump administration may drop the former Biden administration’s lawsuit challenging Idaho’s pro-life law, St. Luke’s Health, the largest health system in Idaho, has filed a lawsuit of its own.

St. Luke’s filed suit against Idaho Attorney General Raúl Labrador on January 14, 2025, to extend pro-abortion protections ensuring that induced abortions — the direct and intentional killing of preborn children — can be carried out in medical emergencies despite such exceptions that already exist in the state’s pro-life law. St. Luke’s Chief Legal Officer Christine Neuhoff said the lawsuit is an attempt “to advocate for our patients and their families who are directly impacted by this conflict between state and federal law.”

And yet, it seems to be disputed as to whether there truly is a conflict between the two.

Idaho’s Law

Idaho defines abortion as “the use of any means to intentionally terminate the clinically diagnosable pregnancy of a woman with knowledge that the termination by those means will, with reasonable likelihood, cause the death of the unborn child…” The law allows for a doctor to perform an induced abortion if he deems in his “good faith medical judgment” that it is truly medically necessary to prevent the woman’s death.

The state’s Defense of Life Act — which protects most preborn children from abortion — also says, “Medical treatment provided to a pregnant woman by a health care professional as defined in this chapter that results in the accidental death of, or unintentional injury to, the unborn child shall not be a violation of this section.” This is important, because in medical emergencies, preterm delivery may be necessary to save a woman’s life, but it would not carry the intent to kill the child; therefore, the death would have been unintentional, yet known to be likely.

The law also notes (emphases added):

The following shall not be considered criminal abortions for purposes of subsection (1) of this section:

(a)  The abortion was performed or attempted by a physician as defined in this chapter and:

(i)  The physician determined, in his good faith medical judgment and based on the facts known to the physician at the time, that the abortion was necessary to prevent the death of the pregnant woman. No abortion shall be deemed necessary to prevent the death of the pregnant woman because the physician believes that the woman may or will take action to harm herself; and

The physician performed or attempted to perform the abortion in the manner that, in his good faith medical judgment and based on the facts known to the physician at the time, provided the best opportunity for the unborn child to survive, unless, in his good faith medical judgment, termination of the pregnancy in that manner would have posed a greater risk of the death of the pregnant woman.

Despite this, leadership at St. Luke’s claims that physicians have been too ‘scared’ of the law — or of their own ‘good faith judgment’ — to induce delivery during a medical emergency.

Dr. Jim Souza, chief physician executive at St. Luke’s, said that St. Luke’s doctors were consistently airlifting patients to other states to receive emergency care because of the pro-life law. However, AG Labrador suggested during a press conference that such a notion is “a political statement.” He said the hospital system talking about the number of patients flown out-of-state for emergency abortions is “misinformation.”

“I have talked to doctors in the ER, the same ER rooms that they’re talking about,” he said, “and they are telling me that they have no idea what this administrator is talking about.”

Nicole Miller’s story made headlines after she was airlifted from St. Luke’s to Utah, where she underwent a D&E (dilation and evacuation) abortion — a procedure in which her baby boy, Maddox David, was dismembered. But this procedure (or any deliberately life-ending procedure) on a living preborn baby is not listed as part of the standard of care for the health complications Miller was experiencing.

Even worse, it appears that Miller was unaware of the dismemberment of her preborn child until she awoke and was informed by a nurse that her son had been killed and removed from her womb. An induced delivery for this baby, though he was just 19 weeks, would have been completely legal in Idaho and he would not have been dismembered. Yet Miller was airlifted to Utah for an abortion — and then the heartbreaking story of her son’s dismemberment was exploited to promote abortion.

The original Biden administration lawsuit

In 2022, the Biden Department of Justice (DOJ) sued the state of Idaho, arguing that its Defense of Life Act violates the federal Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals that receive federal Medicare funds to provide stabilizing treatment to patients in the emergency room during a medical emergency, including a mental health crisis (though the Biden administration later withdrew the provision regarding mental health). The DOJ argued that “stabilizing care” could include induced abortion. This is despite the Idaho law already including an exception for abortion to save the life of the mother. In short, the administration sought the direct and intentional killing of a preborn human being to be included under the category of “stabilizing treatment.”

Idaho asked the Supreme Court to intervene in the case, to which the court agreed, while issuing a stay on an injunction against the law. This allowed the Defense of Life Act to take effect until the Supreme Court decided to send the case back to the Ninth Circuit for review, allowing the injunction to be put back in place. However, that injunction was very narrow, and reads: “During the pendency of this lawsuit, the State of Idaho will be enjoined from enforcing Idaho Code § 18- 622 to the extent that statute conflicts with EMTALA-mandated care. (emphasis added).”

That meant Idaho hospitals receiving Medicaid funding must allow abortions to be committed as “stabilizing care.”

In a footnote on her opinion, Justice Amy Coney Barrett noted that EMTALA does not require Idaho doctors to commit induced abortions (emphasis added):

The United States also clarified that if pregnancy seriously jeopardizes the woman’s health postviability, EMTALA requires delivery, not abortion. Brief for United States 10; Tr. of Oral Arg. 75. And it emphasized that EMTALA requires abortion only in an ’emergency acute medical situation,’ where a woman’s health is in jeopardy if she does not receive an abortion ‘then and there.’ Tr. of Oral Arg. 79–80. These two temporal points also narrow the scope of EMTALA’s potential conflict with Idaho’s Act.

The Idaho Family Policy Council explained, “Because ‘medical emergency’ exceptions have proven just as effective as ‘life of the mother’ exceptions in restricting access to elective abortions, we do not anticipate that the abortion rate in Idaho [will] increase as a result of this ruling.”

At the time, Labrador said:

The Supreme Court sent the case back to the 9th Circuit today after my office won significant concessions from the United States that Justice Barrett described as ‘important’ and ‘critical.’ Today, the court said that Idaho will be able to enforce its law to save lives in the vast majority of circumstances while the case proceeds.

The Biden administration’s concession that EMTALA will rarely override Idaho’s law caused the Supreme Court to ask the 9th Circuit for review in light of the federal government’s change in position.

Justice Barrett wrote, those concessions mean that Idaho’s Defense of Life Act ‘remains almost entirely intact.’ The 9th Circuit’s decision should be easy.

As Justice Alito explained well: the Biden administration’s ‘preemption theory is plainly unsound.’ I remain committed to protect unborn life and ensure women in Idaho receive necessary medical care, and I will continue my outreach to doctors and hospitals across Idaho to ensure that they understand what our law requires. We look forward to ending this administration’s relentless overreach into Idahoans’ right to protect and defend life.

READ: Planned Parenthood’s repeated failure to report child sexual abuse has impacted countless lives

The new St. Luke’s lawsuit against Idaho

Though the injunction forcibly telling doctors they have to commit abortions for emergencies and the law’s exception stating that they can commit abortions in emergencies are similar, St. Luke’s spokesperson Christine Myron admitted to the Idaho Capitol Sun that, since that injunction was put in place, they have unsurprisingly not had to fly anyone out of state for emergencies that needed purported ‘abortion care’. Emergency room patients have “received the full scope of stabilizing care, including termination of the pregnancy if that was medically necessary,” she said, adding, “St. Luke’s physicians have not had to transfer any patients to another state to receive that stabilizing care.” Was it all ‘politically motivated’ as Labrador suggests?

Regardless, Souza wants the exceptions to the law expanded even further, arguing that EMTALA and the Idaho law are in conflict.

“Our physicians are dedicated to helping families bring children into the world with safe, evidence-based care,” he said in a statement. “Yet, the conflict between Idaho’s Defense of Life Act and EMTALA makes it impossible to provide the highest standard of care in some of the most heartbreaking situations.”

Souza, it should be noted, is a pulmonologist — not an obstetrician/gynecologist.

For his part, Labrador vowed to keep fighting to defend the law.

“The U.S. Supreme Court has already ruled that the Constitution does not contain a right to abortion and that laws protecting the sanctity of life are left up to the individual states,” he said in a statement. “There is no conflict between the plain interpretation of Idaho’s Defense of Life Act and EMTALA. Idaho law protects both the life of the mother and their unborn child. Any perceived conflict has been perpetuated by politicians, organizations, and individuals seeking to confuse doctors and jeopardize patient health for political ends.”

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